Effects of Operating Room Sound Levels and Surgical Posture on Surgeon Stress and Workload in Robot-Assisted Surgery: A Pilot Study

This pilot study aims to evaluate the physical and mental stress, as well as workload, experienced by a surgeon during robot-assisted surgery （RAS） from a physiological ergonomics perspective. Specific physiological assessments were conducted on an experienced urologist, focusing on the central nervous system, autonomic nervous system, and musculoskeletal system, to monitor fluctuations in stress-related metrics. Physiological measures including electroencephalography （EEG）, surface electromyography （sEMG）, electrodermal activity （EDA）, heart rate （HR）, and salivary cortisol （sCort） were used alongside workload evaluations via the NASA Task Load Index （NASA-TLX） and Surgical Task Load Index （SURG-TLX） and performance evaluation on the da Vinci Skills Simulator （dVSS）. The Suture Sponge 1 （SS1） and Energy Switching 1 （ES1） exercises were employed as simulated surgical tasks, performed under varying operating room （OR） sound conditions （reduced or normal） and different surgical postures （experienced or novice）. Results indicate that relatively higher sound levels and novice posture both elicit more pronounced stress responses in the participant. Stress responses during shorter tasks showed a stronger correlation with posture, while prolonged tasks were more affected by OR sound levels. These findings highlight the importance of a comprehensive physiological evaluation to mitigate surgeon stress and workload in RAS.